CalTMS - PHQ-9/GAD-7

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First, please tell us your name.* This field is required.All information is securely stored and confidential.

First Name

Last Name

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Your Cell Number* This field is required.Used to verify your health record

Please enter a valid phone number.

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Over the past 2 weeks, how often have you experienced the following?* This field is required.Little interest or pleasure in doing things

Nearly every day

More than half the days

Several days

Not at all

4

Feeling down, depressed, or hopeless* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Trouble falling or staying asleep, or sleeping too much* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Feeling tired or having little energy* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Poor appetite or overeating* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Feeling bad about yourself...or that you are a failure or have let yourself or your family down* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Trouble concentrating on things, such as reading, or watching television* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Thoughts that you would be better off dead, or of hurting yourself* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?* This field is required.Last question for the Depression Quiz.

Extremely difficult

Very difficult

Somewhat difficult

Not difficult at all

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Over the past 2 weeks, how often have you experienced the following?* This field is required.Feeling nervous, anxious, or on edge

Nearly every day

More than half the days

Several days

Not at all

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Not being able to stop or control worrying* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Worrying too much about different things* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Trouble relaxing* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Being so restless that it's hard to sit still* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Becoming easily annoyed or irritable* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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Feeling afraid as if something awful might happen* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

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How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?* This field is required.Last question for the Anxiety Quiz.

Extremely difficult

Very difficult

Somewhat difficult

Not difficult at all

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Results of your PHQ-9The Patient Health Questionnaire (9 questioons) is designed for Depression

Out of 27. Based on PHQ-9.

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Sliders with calculated result

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No symptoms of depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms arise.

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Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

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Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

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Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

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Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

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Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

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Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

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Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

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Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

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Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

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Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

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Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

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Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

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Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

37

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

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Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

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Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

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Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

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Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

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Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.